Dementia presents a variety of challenges to caregivers. In addition to the inevitable decline in memory and physical function, the vast majority of persons with dementia develop one or more troublesome behavior problems such as depression, fearfulness, sleep disturbances, suspiciousness and paranoia, or physical aggression at some point in their disease. [Page 1]

According to the author, 360,000 persons are diagnosed with Alzheimer's disease each year. Seventy percent of these patients are taken care of by family and friends. Their caregivers face a disease that changes constantly. In addition, no two victims will act the same way. There is no way to present a list of expectations for the caregiver so they can be prepared in advance for the various behaviors that will happen. No one will argue that being the care giver for a demented person is hard.

These caregivers need resilience -- the ability to bounce back after problems occur. Therefore, McCurry discusses resilience thoroughly in Section 1, consisting of just chapter one. Unfortunately, many caregivers develop resentfulness or resignation instead of resilience. Stories of various caregivers are shared to illustrate the different ways of responding to the stress of taking care of one of these patients.

She indicates the caregivers that will survive the situation the best are those that are resilient. Chapter one concludes with an exercise -- completing the "Resilience Scale. A caregiver should look it over and indicate whether they disagree or agree with the statement. If you agree with the statement given, it indicates a resilient strength.

Section 2 opens with the story of a husband with a wife suffering from dementia. One of his problems was convincing her to take a shower. One morning he warmed up the bathroom and turned on the shower. Then, he woke her up and asked her to dance with him, something she always enjoyed. He proceeded to undress her, and himself, and danced her right into the shower.

The author uses the acronym, D.A.N.C.E. to describe the whole experience of dealing with a person suffering from any form of dementia and how to be resilient in the process. Chapter 2 deals with "D" -- Don't Argue! She talks about ways caregivers can help the demented person go about their daily activity without constantly arguing with them. I am sure that every caregiver is aware of how useless arguing is -- whether you are talking with a demented adult or a strong willed preschooler. After an excellent discussion, illustrated with true life stories, the author presents an arsenal of communication tools to help.

Chapter two concludes with an exercise on observing the behavior of a person with Alzheimer's. She has two groups of adjectives to use. The first group is full of negatives while the second group is full of positives. Learning to describe the demented person with positive adjectives can improve your communication and who attitude towards them.

The next chapter deals with the "A" in the D.A.N.C.E. acronym. This is finally accepting that your loved one, brother, sister, or other relative or friend really has Alzheimer's disease. It concludes with an exercise illustrating a problem and looking at various ways to deal with the problem as a result of accepting the diagnosis.

"N" is for Nurture Yourself, the topic of chapter four. Care giving wears out a person. It frequently means you're participating in fewer of your normal activities because of the difficulty of taking your spouse with you or because you don't want to leave them behind for some time for yourself. Chapter four ends with an exercise in describing the quality of life for the patient. You rank things like physical health or friends as being Poor, Fair, Good, or Excellent. Then you evaluate the answers to see if there is something more you need to do to help the patient.

Chapter five is called "Create Novel Solutions". It will teach you some ways of coming up with solutions to the various problems that are part of the Alzheimer's experience. I particularly enjoyed one idea where a daughter finally got a second telephone number. Her mother could call the original number as many times as she wanted to be reminded of what they would be doing. This way her mother got the endless reminders and Mary didn't have to be on the telephone constantly.

The final chapter (6) deals with E: Enjoy the Moment. Both caregivers and patients give up many activities they used to enjoy either separately or together. This chapter helps you begin to find ways for enjoying some activities again. They may not be the same things as before due to the patient's decline. However, it is important to find something that will add a little enjoyment and humor back into your lives. The exercise at the end of this chapter will guide you as you come up with ideas on how to achieve this.

Section three reminds you, "You can do it!" It serves as encouragement in dealing with a very discouraging situation.

Recommendation

Reading this book was difficult because it describes the situation my father is dealing with daily now--a wife with Alzheimer's disease. I've already shared the story of getting a wife to take a shower with family members during my mother's most recent hospitalization. They all had a good laugh.

When a Family Member has Dementia also showed me just how good my father is at care giving. He demonstrated his creativity when dealing with one problem. Mother always wants to go home after supper and waits for her father (really my father) to pick her up. She puts some of her belongings in plastic bags, puts on her coat, gets her purse and announces that she is ready. Dad has taken to driving her around their block or even the neighborhood. Then he pulls into their driveway. She now believes she is back home.

If you are a caregiver, you need this book! It may be beneficial for you to have family and friends read it to understand the D.A.N.C.E. principles. This way you will be on the same page when coming up with possible solutions to the many problems faced by caregivers and their patients. I suggest that physicians and other professionals treating Alzheimer's patients have this book in their waiting rooms and on their office shelves. Tell caregivers about it -- it will help them survive this situation without become totally frustrated themselves.

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